Emergency doctors urged to 'Think Aorta'

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Emergency doctors are being urged to collaborate with a patient-led campaign, which aims to reduce the number of patients dying in Irish Emergency Departments (EDs) from aortic dissection.

An aortic dissection refers to a tear in the body's largest artery that carries blood away from the heart. Unless the condition is diagnosed rapidly and the patient undergoes surgery, it can prove fatal.

However, symptoms can be similar to other heart problems, such as a heart attack, which can lead to a misdiagnosis or a delay in diagnosis.

A patient support association, Aortic Dissection Awareness (UK and Ireland), is challenging the number of unnecessary deaths that occur due to the misdiagnosis of this condition in Irish hospitals.

It is calling on the Irish Association for Emergency Medicine (IAEM) to collaborate with it and introduce changes in relation to education, awareness and policy around the condition.

The chairperson, vice-chairperson and medical advisor of this patient association are attending the IAEM's annual scientific meeting and conference in Dublin this week to urge doctors to get involved with the 'Think Aorta' campaign.

This campaign was inspired by the death of Tim Fleming, who was sent home from Dublin's Tallaght Hospital in 2015 with an incorrect diagnosis of gastritis. Mr Fleming's daughter, Catherine Fowler, who is vice-chairperson of Aortic Dissection Awareness, is a guest speaker at the conference.

"We had no idea when dad died of how common it is for aortic dissection to be missed in the ED. Over the last three years, the picture has become very clear. Sadly, I know of many other families in Ireland who have lost their relatives to missed aortic dissection in hospitals during that time. We must do something to change the future for others," she said.

She pointed out that as a result of the ‘Think Aorta' campaign in the UK, the Royal College of Emergency Medicine there has accepted that this is a real issue and it is working with the association to address this.

"I will be asking the IAEM to do the same," Ms Fowler added.

Statistics show that aortic dissection is only considered in half of the patients who present with it, and one-third of patients are actively treated for something else, such as a heart attack.

The only definitive diagnostic tool for diagnosing the condition is a CT scan, however these are often not ordered until it is too late.

"Aortic dissection is not a difficult condition to diagnose. A doctor just has to be aware enough to ‘Think Aorta' in the first place, then once their suspicion is raised, they must request an immediate CT scan to confirm.

"Experience in the UK shows that if EDs educate staff about aortic dissection and lower the barriers to CT scanning, lives will be saved," Ms Fowler noted.

The IAEM annual scientific meeting and conference takes place in Castleknock Hotel from October 17-19. For more information on the ‘Think Aorta' campaign, click here